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https://www.readbyqxmd.com/read/28633544/medical-versus-surgical-management-of-penetrating-crohn-s-disease-the-current-situation-and-future-perspectives
#1
Seema A Patil, Raymond K Cross
The development of penetrating Crohn's disease (CD) occurs in up to 50% of patients over the course of their lifetime. While the presentation of these complications, including free perforation, intra-abdominal abscess, and enteric fistula, are usually obvious, the management can require a nuanced approach, with distinct short and long-term approaches. Areas covered: This review discusses medical and surgical methods of treating these complications, including the role of percutaneous drainage of abscesses, the implications of a stricture associated with a fistula, and the efficacy of postoperative anti-TNF therapy in preventing recurrence after surgical treatment...
June 21, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28628705/time-to-appendectomy-and-risk-of-complicated-appendicitis-and-adverse-outcomes-in-children
#2
Stephanie K Serres, Danielle B Cameron, Charity C Glass, Dionne A Graham, David Zurakowski, Mahima Karki, Seema P Anandalwar, Shawn J Rangel
Importance: Management of appendicitis as an urgent rather than emergency procedure has become an increasingly common practice in children. Controversy remains as to whether this practice is associated with increased risk of complicated appendicitis and adverse events. Objective: To examine the association between time to appendectomy (TTA) and risk of complicated appendicitis and postoperative complications. Design, Setting, and Participants: In this retrospective cohort study using the Pediatric National Surgical Quality Improvement Program appendectomy pilot database, 2429 children younger than 18 years who underwent appendectomy within 24 hours of presentation at 23 children's hospitals from January 1, 2013, through December 31, 2014, were studied...
June 19, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28626377/kidney-injury-due-to-ureteral-obstruction-caused-by-compression-from-infected-simple-hepatic-cyst
#3
Naoya Sawada, Tetsu Endo, Kenichiro Mikami, Go Igarashi, Juichi Sakamoto, Hiroshi Tono, Shinsaku Fukuda
Simple hepatic cysts are common and most often asymptomatic. In symptomatic cases, hemorrhage, rupture, and infection are major complications. However, urinary tract obstruction caused by a simple hepatic cyst is rare. We treated an 82-year-old Japanese man with an infected giant hepatic cyst causing right hydronephrosis who had a past history of left nephrectomy for renal cell carcinoma. The patient underwent ultrasound-guided percutaneous drainage and sclerotherapy with minocycline hydrochloride for the infected hepatic cyst...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28626373/biliary-pleural-fistula-following-portal-vein-embolization-for-perihilar-cholangiocarcinoma
#4
Mujtaba Mohammed, Katsuhiro Kobayashi, Mohammed Jawed
Biliary-pleural fistula (BPF), an abnormal communication between the biliary tract and pleural space, is a rare but potentially life-threatening complication following percutaneous biliary intervention. We report a case of BPF following portal vein embolization (PVE) in a 79-year-old woman with obstructive jaundice secondary to perihilar cholangiocarcinoma. The patient successfully underwent right-sided PVE; however, the patient developed a symptomatic right-sided bilious pleural effusion the following day...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28621299/conversion-of-transpapillary-drainage-to-endoscopic-ultrasound-guided-hepaticogastrostomy-and-gallbladder-drainage-in-a-case-of-malignant-biliary-obstruction-with-recurrent-cholangitis-and-cholecystitis-with-videos
#5
Yousuke Nakai, Hiroyuki Isayama, Saburo Matsubara, Kazuhiko Koike
Endoscopic ultrasound-guided biliary drainage (EUS-BD) has been increasingly reported as an alternative to percutaneous transhepatic biliary drainage in failed endoscopic retrograde cholangiopancreatography. Moreover, conversion to EUS-BD can be a good alternative when transpapillary biliary drainage is technically possible but complicated by cholangitis because EUS-BD enables one-step internal drainage not traversing the tumor. Herein, we report a case of recurrent cholangitis due to hemobilia and cholecystitis due to tumor involvement to the cystic duct after transpapillary stent placement, which was successfully managed by conversion to EUS-BD and EUS-guided gallbladder drainage in one session...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28621295/efficacy-and-safety-in-case-of-technical-success-of-endoscopic-ultrasound-guided-transhepatic-antegrade-biliary-drainage-a-report-of-a-monocentric-study
#6
Sébastien Godat, Erwan Bories, Fabrice Caillol, Christian Pesenti, Jean Philippe Ratone, Chiara de Cassan, Marc Giovannini
BACKGROUND AND OBJECTIVES: Endoscopic ultrasound (EUS)-guided biliary drainage techniques are alternative procedures in cases of obstructive jaundice with altered anatomy or failed ERCP. Complications related to EUS-guided antegrade drainage (EUS-AD) are still present in up to 10% of cases, and combination of procedures is sometimes suggested to avoid adverse events. The purpose of our study is to evaluate the efficacy and safety of EUS-AD with transhepatic access in case of technical success...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28616405/endoscopic-treatment-for-distal-malignant-biliary-obstruction
#7
REVIEW
Kazuya Matsumoto, Yohei Takeda, Takumi Onoyama, Soichiro Kawata, Hiroki Kurumi, Hiroki Koda, Taro Yamashita, Hajime Isomoto
Distal malignant biliary obstruction (MBO) leads to obstructive jaundice as a result of when the bile excretion from the liver is disturbed and induces hepatic failure and sepsis, which when complicated with cholangitis, it becomes necessary to perform drainage for the MBO. For biliary drainage, we can perform a surgical bypass operation, percutaneous transhepatic biliary drainage (PTBD), endoscopic biliary drainage (EBD) via duodenal papilla, or endoscopic ultrasound (EUS)-guided biliary drainage (EUS-BD), which is a transgastrointestinal biliary drainage...
April 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28608041/laparoscopic-lavage-in-the-management-of-perforated-diverticulitis-a-contemporary-meta-analysis
#8
Norman Galbraith, Jane V Carter, Uri Netz, Dongyan Yang, Donald E Fry, Michael McCafferty, Susan Galandiuk
IMPORTANCE: Perforated diverticulitis carries the risk of significant comorbidity and mortality. Although colon resection provides adequate source control, the procedure itself carries morbidity, as well as later stoma reversal procedures. The effectiveness of laparoscopic lavage to treat perforated diverticulitis remains unclear. OBJECTIVE: We aimed to conduct a meta-analysis to evaluate current studies comparing laparoscopic lavage with colon resection in cases of perforated diverticulitis for the effectiveness in source control, without the need for subsequent interventions, stoma formation, and death...
June 12, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28603813/-french-comment-on-article-endoscopic-ultrasound-guided-gallbladder-drainage-reduces-adverse-events-compared-with-percutaneous-cholecystostomy-in-patients-who-are-unfit-for-cholecystectomy1
#9
https://www.readbyqxmd.com/read/28603003/double-j-stenting-prior-to-cystectomy-is-an-independent-risk-factor-for-upper-urinary-tract-recurrence
#10
Bernhard Kiss, Marc A Furrer, Patrick Y Wuethrich, Fiona C Burkhard, George N Thalmann, Beat Roth
PURPOSE: Bladder cancer patients presenting with hydronephrosis may require drainage of the affected kidney before receiving further cancer treatment. Drainage can be done by retrograde stenting or percutaneously. Retrograde stenting, however, bears the risk of tumour cell spillage to the upper urinary tract. The aim of this study was to evaluate whether bladder cancer patients are at higher risk of upper urinary tract recurrence if retrograde stenting has been performed prior to radical cystectomy...
June 8, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28598807/renal-lymphangiectasia-treated-with-percutaneous-drainage-and-sclerotherapy
#11
Sunirmal Choudhury, Kartik Sridhar, Dilip Kumar Pal
Renal lymphangiectasia is a rare benign condition of the lymphatic system. Primarily, the diagnosis is based upon characteristic imaging findings along with biochemical analysis of aspirated fluid. No definitive algorithm exists for treating this condition owing to its rarity. The literature describes various modes of management ranging from conservative management to nephrectomies. We present a case of bilateral renal lymphangiectasia managed with percutaneous drainage along with sclerotherapy. Our initial findings show a favorable outcome with this approach...
June 9, 2017: International Journal of Adolescent Medicine and Health
https://www.readbyqxmd.com/read/28598298/efficacy-of-exclusive-enteral-nutrition-in-complicated-crohn-s-disease
#12
Qingfan Yang, Xiang Gao, Huiping Chen, Miao Li, Xiaojian Wu, Min Zhi, Ping Lan, Pinjin Hu
AIM: To investigate the efficacy of exclusive enteral nutrition (EEN) in induction of remission in adult active Crohn's disease (CD) complicated with intestinal fistula/abdominal abscess or inflammatory intestinal stricture. METHOD: Patients diagnosed with active CD with complications were recruited between July 2013 and July 2015. Patients were offered EEN for 12 weeks. Patients with abscess received antibiotic treatment with or without percutaneous drainage. Clinical variables were recorded (ClinicalTrials...
June 9, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28597036/outpatient-drainmanagement-of-patients-with-clinically-relevant-postoperative-pancreatic-fistula-popf
#13
Sebastian Hempel, Steffen Wolk, Christoph Kahlert, Stephan Kersting, Jürgen Weitz, Thilo Welsch, Marius Distler
PURPOSE: Postoperative pancreatic fistula (POPF) is a common complication after pancreatic surgery associated with extended hospitalization, increased medical costs, and reduced quality of life. The aim of the present study was to analyze the feasibility of ambulatory drainage and develop an ambulatory management algorithm. METHODS: Patients with POPF grade B or C (according to the ISGPF classification) between Jan. 2005 and Dec. 2014 that required persistent drainage were identified from a prospectively collected database...
June 8, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28593157/early-aggressive-surgical-treatment-of-multiloculated-empyema
#14
Jong Hyun Baek, Young Uk Lee, Seok Soo Lee, Jang Hoon Lee, Jung Cheul Lee, Myeong Su Kim
BACKGROUND: Empyema is the collection of purulent exudate within the pleural space. Overall, 36%-65% of patients with empyema cannot be treated by medical therapy alone and require surgery. Multiloculated empyema is particularly difficult to treat with percutaneous drainage. Therefore, we describe our experiences with early aggressive surgical treatment for rapid progressive multiloculated empyema. METHODS: From January 2001 to October 2015, we retrospectively reviewed 149 patients diagnosed with empyema who received surgery...
June 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28593017/the-rendezvous-technique-involving-insertion-of-a-guidewire-in-a-percutaneous-transhepatic-gallbladder-drainage-tube-for-biliary-access-in-a-case-of-difficult-biliary-cannulation
#15
Fumiko Sunada, Naoki Morimoto, Mamiko Tsukui, Hidekazu Kurata
Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic method and treatment approach for biliary diseases. However, biliary cannulation can be difficult in some cases. We performed ERCP in a 97-year-old woman with abdominal pain resulting from acute cholangitis caused by choledocholithiasis and observed difficult biliary cannulation. Eventually, the patient was successfully treated with the rendezvous technique. We could not cannulate the biliary duct during ERCP twice. Therefore, we placed a percutaneous transhepatic gallbladder drainage (PTGBD) tube without intrahepatic dilation...
May 2017: Journal of Rural Medicine: JRM
https://www.readbyqxmd.com/read/28590353/proposed-clinical-pathway-for-non-operative-management-of-high-grade-pediatric-pancreatic-injuries-based-on-a-multicenter-analysis-a-pediatric-trauma-society-collaborative
#16
Bindi J Naik-Mathuria, Eric H Rosenfeld, Adam Vogel, Ankush Gosain, Randall Burd, Richard A Falcone, Rajan Thakkar, Barbara Gaines, David Mooney, Mauricio Escobar, Mubeen Jafri, Anthony Stallion, Denise B Klinkner, Robert Russell, Brendan Campbell, Rita V Burke, Jeffrey Upperman, David Juang, Shawn St Peter, Stephon J Fenton, Marianne Beaudin, Hale Wills, Stephanie Polites, Adam Pattyn, Christine Leeper, Laura V Veras, Ilan Maizlin, Shefali Thaker, Alexis Smith, Megan Waddell, Joseph Drews, James Gilmore, Lindsey Armstrong, Alexis Alex Ler, Suzanne Moody, Brandon Behrens, Laurence Carmant
BACKGROUND: Guidelines for non-operative management (NOM) of high-grade pancreatic injuries in children have not been established, and wide practice variability exists. The purpose of this study was to evaluate common clinical strategies across multiple pediatric trauma centers in order to develop a consensus-based standard clinical pathway. METHODS: A multicenter, retrospective review was conducted of children with high-grade (AAST grade III-V) pancreatic injuries treated with NOM between 2010-15...
June 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28589507/biliary-stone-removal-through-the-percutaneous-transhepatic-biliary-drainage-route-focusing-on-the-balloon-sphincteroplasty-flushing-technique-a-single-center-study-with-916-patients
#17
Jong Soo Shin, Hyung Jin Shim, Byung Kook Kwak, Hyun-Ki Yoon
PURPOSE: To present our experience in biliary stone removal (BSR) through the percutaneous transhepatic biliary drainage (PTBD) route in 916 patients, and discuss its clinical usefulness. MATERIALS AND METHODS: From 2001 to 2015, 916 patients (479 male patients and 437 female patients; age range, 22-92 years; mean age, 67 years) with 52 recurring cases, so a total of 968 cases, were enrolled in this study and retrospectively reviewed. PTBD was performed in all patients...
June 6, 2017: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/28588794/intrahepatic-biloma-following-transcatheter-arterial-chemoembolization-for-hepatocellular-carcinoma-incidence-imaging-features-and-management
#18
Bo Zhang, Yongjian Guo, Ketong Wu, Hong Shan
Repeat transcatheter arterial chemoembolization (TACE) becomes more challenging for patients with intrahepatic biloma following TACE for hepatocellular carcinoma (HCC). The purpose of this study was to investigate the clinical course, incidence, imaging features and outcome and to explore the reasonable therapy scheme for intrahepatic biloma following TACE for HCC.A total of 4,695 TACE procedures were performed for 1,923 patients with HCC. Twenty patients with intrahepatic biloma following TACE were studied retrospectively...
June 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28584946/post-procedural-care-in-interventional-radiology-what-every-interventional-radiologist-should-know-part-ii-catheter-care-and-management-of-common-systemic-post-procedural-complications
#19
Bedros Taslakian, Divya Sridhar
Interventional radiology (IR) has evolved into a full-fledged clinical specialty with attendant comprehensive patient care responsibilities. Providing excellent and thorough clinical care is as essential to the practice of IR as achieving technical success in procedures. Basic clinical skills that every interventional radiologist should learn include routine management of percutaneously inserted drainage and vascular catheters and rapid effective management of common systemic post-procedural complications. A structured approach to post-procedural care, including routine follow-up and early identification and management of complications, facilitates efficient and thorough management with an emphasis on quality and patient safety...
June 5, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28584681/abdominal-pseudocyst-as-a-complication-of-ventriculoperitoneal-shunt-placement-review-of-the-literature-and-a-proposed-algorithm-for-treatment-using-4-illustrative-cases
#20
Samir Kashyap, Hammad Ghanchi, Tanya Minasian, Fanglong Dong, Dan Miulli
BACKGROUND: Ventriculoperitoneal (VP) shunt placement is one of the most commonly performed procedures in neurosurgery. One rare complication is the formation of an abdominal pseudocyst, which can cause shunt malfunction. CASE DESCRIPTIONS: We present four unique cases of abdominal pseudocyst formation. Our first patient initially presented with a right upper quadrant pseudocyst. Shunt was externalized and the distal end was revised with placement of catheter on the opposite side...
2017: Surgical Neurology International
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